Pfizer, 50 Pequot Avenue, New London, CT 06320, USA.
Eur J Clin Microbiol Infect Dis. 2010 Mar;29(3):353-6. doi: 10.1007/s10096-009-0862-x. Epub 2010 Jan 30.
While the development of resistance to a new antibiotic is expected, the time course and degree of resistance that will develop are uncertain. Some best projections of the future extent of resistance can be highly impactful for activities, such as antimicrobial development, that require significant lead time. We focus on the surge among hospital isolates in fluoroquinolone-resistant Escherichia coli and use data on resistance and consumption to explore and quantify trends in increasing resistance and their relationship to antibiotic use from 2001 to 2007. A mixed-effects logistic regression model produced a good fit to the observed resistance rates during this period in the United States and Europe. The model contained significant effects of time, consumption, and country on developing fluoroquinolone resistance in E. coli. There was a larger projected increase in resistance for high fluoroquinolone-consuming countries projected to 2013: 45% (95% confidence interval [CI]: 38%, 53%) for high consumers vs. 33% (95% CI: 25%, 41%) for low consumers. The model was also used to obtain regional projections of resistance that can be used by local prescribers. In order to better understand and predict trends in antimicrobial resistance, it is vital to implement and expand current surveillance systems.
虽然预计会出现对抗生素的耐药性，但耐药性的发展速度和程度是不确定的。对未来耐药性程度的最佳预测可能对需要大量前期准备的活动（如抗菌药物开发）产生重大影响。我们专注于氟喹诺酮类耐药大肠杆菌医院分离株的激增，并利用耐药性和使用数据来探索和量化 2001 年至 2007 年间耐药性增加的趋势及其与抗生素使用的关系。混合效应逻辑回归模型很好地拟合了美国和欧洲在此期间观察到的耐药率。该模型包含了时间、消费和国家对大肠杆菌产生氟喹诺酮耐药性的显著影响。对于预计到 2013 年氟喹诺酮高消费国家，预计耐药性会增加更多：高消费者为 45%（95%置信区间[CI]：38%，53%），而低消费者为 33%（95% CI：25%，41%）。该模型还用于获得耐药性的区域预测，供当地处方者使用。为了更好地了解和预测抗菌药物耐药性的趋势，实施和扩大当前的监测系统至关重要。
